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已发表论文
基于光学相干断层扫描的生物标志物与抗血管内皮生长因子治疗后糖尿病性黄斑水肿复发情况的分析
Authors Zhu T, Wang Y, Hua Y, Zha X, Xu T
Received 26 July 2025
Accepted for publication 23 October 2025
Published 13 November 2025 Volume 2025:18 Pages 6941—6948
DOI https://doi.org/10.2147/IJGM.S556385
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 4
Editor who approved publication: Dr Brian C. Gilger
Tingting Zhu, Yuanyuan Wang, Yanting Hua, Xiangming Zha, Tingjun Xu
Department of Ophthalmology, Pinghu First People’s Hospital, Pinghu, 314200, People’s Republic of China
Correspondence: Tingjun Xu, Email tcnjac@163.com
Objective: To identify pre-treatment optical coherence tomography (OCT) biomarkers predictive of recurrence in eyes with diabetic macular edema (DME) after anti-VEGF therapy.
Methods: This retrospective cohort study included 122 eyes with DME treated with anti-VEGF monotherapy (ranibizumab; Novartis Pharma Schweiz AG, Basel, Switzerland) at Pinghu First People’s Hospital (January 2020 – December 2023). The treatment protocol consisted of 3 monthly loading doses followed by a pro re nata (PRN) regimen. Patients were stratified into recurrence (n=54) and non-recurrence (n=68) groups based on predefined criteria during 12 months of follow-up. Baseline OCT parameters were compared, and multivariate logistic regression was used to identify independent predictors. A combined model’s predictive performance was assessed using receiver operating characteristic (ROC) curve analysis.
Results: The recurrence group had significantly higher baseline central retinal thickness (452.7± 84.3 vs 391.5± 70.2 μm, P=0.002), subretinal fluid (SRF) prevalence (63.0% vs 36.8%, P=0.008), proportion with ≥ 5 hyperreflective foci (HRF) (68.5% vs 35.3%, P< 0.001), and ellipsoid zone (EZ) disruption rate (57.4% vs 30.9%, P=0.006), and required more injections (6.4± 1.3 vs 4.8± 1.2, P< 0.001). Multivariate analysis confirmed HRF ≥ 5 (OR=3.52, P< 0.001), SRF presence (OR=2.89, P=0.007), and EZ disruption (OR=2.41, P=0.023) as independent risk factors. Their combined model predicted recurrence with an AUC of 0.841.
Conclusion: HRF, SRF, and EZ integrity are key OCT biomarkers for DME recurrence. A combined model aids risk stratification for personalized management.
Keywords: diabetic macular edema, anti-VEGF therapy, optical coherence tomography, biomarker, recurrence, prediction
Department of Ophthalmology, Pinghu First People’s Hospital, Pinghu, 314200, People’s Republic of China
Correspondence: Tingjun Xu, Email tcnjac@163.com
Objective: To identify pre-treatment optical coherence tomography (OCT) biomarkers predictive of recurrence in eyes with diabetic macular edema (DME) after anti-VEGF therapy.
Methods: This retrospective cohort study included 122 eyes with DME treated with anti-VEGF monotherapy (ranibizumab; Novartis Pharma Schweiz AG, Basel, Switzerland) at Pinghu First People’s Hospital (January 2020 – December 2023). The treatment protocol consisted of 3 monthly loading doses followed by a pro re nata (PRN) regimen. Patients were stratified into recurrence (n=54) and non-recurrence (n=68) groups based on predefined criteria during 12 months of follow-up. Baseline OCT parameters were compared, and multivariate logistic regression was used to identify independent predictors. A combined model’s predictive performance was assessed using receiver operating characteristic (ROC) curve analysis.
Results: The recurrence group had significantly higher baseline central retinal thickness (452.7± 84.3 vs 391.5± 70.2 μm, P=0.002), subretinal fluid (SRF) prevalence (63.0% vs 36.8%, P=0.008), proportion with ≥ 5 hyperreflective foci (HRF) (68.5% vs 35.3%, P< 0.001), and ellipsoid zone (EZ) disruption rate (57.4% vs 30.9%, P=0.006), and required more injections (6.4± 1.3 vs 4.8± 1.2, P< 0.001). Multivariate analysis confirmed HRF ≥ 5 (OR=3.52, P< 0.001), SRF presence (OR=2.89, P=0.007), and EZ disruption (OR=2.41, P=0.023) as independent risk factors. Their combined model predicted recurrence with an AUC of 0.841.
Conclusion: HRF, SRF, and EZ integrity are key OCT biomarkers for DME recurrence. A combined model aids risk stratification for personalized management.
Keywords: diabetic macular edema, anti-VEGF therapy, optical coherence tomography, biomarker, recurrence, prediction